CARE HOMES FOR OLDER PEOPLE
St Georges Nursing Home 2 - 4 Marine Drive Fairhaven Lytham St Annes, Lancashire, FY8 1AU Lead Inspector
Lynne Lynch Unannounced 01 June 2005 9:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service St Georges Nuring Home Address 2 - 4 Marine Drive, Fairhaven, Lytham St Annes, Lancashire, FY8 1AU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01253 730502 reception@centuryhealthcare.co.uk Century Healthcare Limited Mrs Marie Noblett Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (27), Physical disability (2) of places St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21st February 2005 Brief Description of the Service: St.Georges Care Home with Nursing offers care and nursing to 29 Service Users with physical and medical needs. The Home is situated within five minutes walk of the Fairhaven Lake complex and is in within reach of local shops a post-office, and churches. There are regular bus services and Ansdell Railway Station is 10-minute walk away.Accommodation is provided in a detached Victorian Property, which has been modernised to suit the needs of the service users while still encapsulating the many original features of this period. St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced, started at 09.30 am and took place over five hours. The inspector spoke to seven residents living at the home, the person in charge and the manager briefly. A partial tour of the premises took place, staff and care records were inspected and some of the written policies were viewed. What the service does well: What has improved since the last inspection? What they could do better:
The home has improved its Care Planning process, however residents or their representatives should be involved more in this process wherever possible. Contracts and Care Plans should be signed either by the service user or an appropriate representative. The home is currently transferring care planning information onto a different format which they feel will be an improvement. Pureed diets should be prepared in separate elements; all foods should not be mixed together providing a colourless unattractive meal. St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 People are not admitted to St Georges Nursing Home solely for intermediate care. EVIDENCE: St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 Residents welfare is closely monitored and health, personal and social care needs are noted. EVIDENCE: Three residents plans were viewed. They set out in detail the action that needed to be taken by care staff to ensure all aspects of health, personal and social care needs of the residents were met. Significant events had been recorded and daily entries made setting out the care given. Care plans are reviewed monthly. The manager advised that a new care plan format is soon to be introduced. One resident spoken to was aware of their care plan and confirmed their involvement in their care however not all care plans were signed and resident involvement should be further encouraged. One lady said “the home is wonderful I had high standards at home, staff are wonderful I can’t find fault with my care”. St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 Meals in the home are varied and nutritious. Pureed meals are unattractive in presentation. Activities are varied and provide interest for people living in the home. EVIDENCE: A number of residents were spoken to in respect of the food in the home all felt that the food was good. The chef speaks to all residents virtually on a daily basis to canvass opinion. One lady confirmed that she was diabetic and her needs were met. Another lady said the food was nice but she got too much. Pureed meals were observed to be prepared in an unattractive manner with all elements of the meal being pureed together it was recommended that these be pureed separately .The manager advised that the chef is soon to attend a course to address this. One staff member is designated to arrange activities for residents on a daily basis. Activities were varied and arranged individually and in groups. Most residents said they were satisfied with activities provided by the home although one resident said she would like to visit the theatre and hadn’t been able to do this. Residents said that in good weather the home put a gazebo in the grounds enabling them to enjoy the sun this seemed to be very popular. Several of the residents said they enjoyed sitting chatting in the conservatory and the quizzes in the home also appeared popular “they keep my mind active”.
St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and18 Complaints are handled objectively and residents are confident that their concerns will be listened to and acted upon. The home has a procedure in place to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a detailed complaints procedure and the complaint records viewed indicated that the process is followed .One lady spoken to confirmed that a complaint she made was appropriately responded to. No complaints have been received by the CSCI over the past year. A procedure for responding to allegations of abuse is available in the home. This was the policy of the week and was in a plastic wallet on the office wall. Staff are actively encouraged to read the policy of the week and sign once they have, enabling the manager to monitor this and ensure policies and procedures are working documents. St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of the above standards were inspected at this visit. EVIDENCE: St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 Well established procedures for the recruitment of staff provide safeguards for the protection of people living at the home. EVIDENCE: The home has robust recruitment and selection processes in place and staff files show that information required by regulation is maintained including references and employment checks. CSCI inspectors have previously viewed the criminal records bureau disclosures for all staff within the organisation. New staff do not commence duty without the required checks taking place. St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of the above standards were inspected at this visit. EVIDENCE: St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 15 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 2
COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 16 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Service user plans should be signed Timescale for action 31/08/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP15 Good Practice Recommendations Pureed meals should be presented with each element liquidised separately to preserve the taste of the food and enhance presentation. St Georges Nursing Home F57 F09 S6086 St Georges V220216 050505 Stage 4.doc Version 1.30 Page 17 Commission for Social Care Inspection Unit 1, Tustin Court Portway Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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